The effect of single-dose esmolol on hemodynamic responses and BIS values to tracheal intubation and postoperative recovery during the sevoflurane and desflurane anesthesia in patients over the age of 65

Objective: The purpose of this study was to investigate whether single dose of esmolol could supress tracheal intubation -induced hemodynamic responses and BİS values and postoperative recovery during the sevoflurane and desflurane anesthesia in elderly patients. Materials And Methods; ASA class II-III, 80 patients older than 65 years , scheduled for elective surgery were enrolled in this study. The patients were monitored routinely. In addition, BIS monitoring was performed to determine the depth of anesthesia. Patients were randomly divided into 4 groups; in group I sevoflurane, in group II desflurane, in group III sevoflurane and esmolol and in group IV desflurane and esmolol. One minute before endotracheal intubation, either 1 mg/kg of esmolol or normal saline (same volume) was administered intravenously to patients.BIS , systolic and diastolic arterial pressure (SAP, DAP), and heart rate (HR) were recorded before induction of anesthesia (awake, basic), after induction agents, after esmolol injection, during intubation and 30.sn, 1 min, 3 min and 5 min after endotracheal intubation. At the end of the operation extubation time, eye opening time, and awakening time were recorded. Perioperative complications were recorded. P <0 .05 was considered statistically significant. Results: There were no significant differences in demographic data between study groups (P>0,05). Systolic and diastolic blood pressures were lower in the groups treated with esmolol. No patient developed systolic blood pressure <80mm Hg.. Adequate depth of anesthesia were achieved in all cases. A single dose of esmolol blunted the increase in BIS to endotracheal intubation during sevoflurane and desflurane anesthesia. Compared with the other groups, the recovery times, eye opening, response to simple commands, extubation, and orientation were significantly shorter in esmolol treated groups ( p=0,0001). Aldrete scores were similar in all groups at postoperative 5?, 15?, 30? minutes. In conclusion, a single dose of esmolol blunted the increase in BIS and hemodynamic variables to endotracheal intubation during sevoflurane and desflurane anesthesia İn elderly patients. Administration of a single dose esmolol eye-opening, alertness time and extubation time were shortened. Keywords: Sevoflurane, desflurane, esmolol, bispectral index, postoperative recovery